First Reported Use of Highly Adsorptive Hemofilter in Critically Ill COVID-19 Patients in the USA.

Critically ill patients with coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) develop respiratory failure and septic shock. Extracorporeal blood purification is proposed as an adjuvant therapy for sepsis and aims at controlling the dysregulated autoimmune system. We describe our experience in treating COVID-19 patients with the oXiris hemofilter which adsorbs both cytokines and endotoxins, provides renal replacement therapy and has anti-thrombogenic properties.

Protocol driven outcomes in renal parathyroid surgery.

Background: Patients who require surgery for renal hyperparathyroidism represent a special population that is at high risk for postoperative complications. To optimize their treatment, we developed a multidisciplinary approach to the perioperative management of these patients undergoing parathyroidectomy.

Methods: The Augusta University endocrine surgery parathyroid database was interrogated to identify dialysis-dependent patients undergoing parathyroidectomy from 2005 to 2015.

Combined endothelin a blockade and chlorthalidone treatment in a rat model of metabolic syndrome.

Experiments determined whether the combination of endothelin A (ETA) receptor antagonist [ABT-627, atrasentan; (2R,3R,4S)-4-(1,3-benzodioxol-5-yl)-1-[2-(dibutylamino)-2-oxoethyl]-2-(4-methoxyphenyl)pyrrolidine-3-carboxylic acid] and a thiazide diuretic (chlorthalidone) would be more effective at lowering blood pressure and reducing renal injury in a rodent model of metabolic syndrome compared with either treatment alone. Male Dahl salt-sensitive rats were fed a high-fat (36% fat), high-salt (4% NaCl) diet for 4 weeks. Separate groups of rats were then treated with vehicle (control), ABT-627 (ABT; 5 mg/kg per day, in drinking water), chlorthalidone (CLTD; 5 mg/kg per day, in drinking water), or both ABT plus CLTD.

Antihypertensive and anti-inflammatory actions of combined azilsartan and chlorthalidone in Dahl salt-sensitive rats on a high-fat, high-salt diet.

Metabolic syndrome (MetS) and chronic kidney disease are global health issues. Metabolic syndrome induces hypertension and commonly results in renal damage. The optimal therapy for hypertension in MetS is unknown.

Differential regulation of nitric oxide synthase function in aorta and tail artery from 5/6 nephrectomized rats.

Chronic renal failure (CRF) is associated with hypertension and concomitant endothelial dysfunction, enhanced vasoconstriction, and nitric oxide synthase (NOS) dysfunction. Vascular function in patients is assessed in peripheral extremity arteries like the finger arteries, whereas animal studies often use the centrally located aorta. Therefore, we examined whether peripheral tail artery and aortic NOS function are differentially regulated by blood pressure in rats with CRF.

Tubular injury marker netrin-1 is elevated early in experimental diabetes.

Background: Netrin-1 was recently identified as an early diagnostic biomarker of acute kidney injury. However, its usefulness for early diagnosis of chronic kidney disease (CKD) is unknown. The current study evaluated whether these proteins are increased in urine from experimental animals with diabetes.

Should arteriovenous fistulas and synthetic grafts undergo surveillance with pre-emptive correction of stenosis?

This Practice Point commentary discusses Tonelli et al.'s systematic review and meta-analysis of randomized controlled trials that evaluated surveillance of hemodialysis accesses. Tonelli et al.

Internal hernia of the transverse colon-Chilaiditi syndrome in a child.

A redundant loop of transverse colon was herniated symptomatically behind the right liver to a suprahepatic, subdiaphragmatic position in an 11-year-old girl (Chilaiditi Syndrome). Constipation from birth, partial obstruction, and recurrent severe right upper quadrant pain unresponsive to nonoperative management warranted transverse colectomy.

Concomitant Spigelian and inguinal hernias in a neonate.

A Spigelian hernia presented concurrently with bilateral inguinal hernias in a 1-month-old infant. This case emphasizes that a Spigelian hernia can occur in neonates and synchronously with an inguinal hernia. Analysis suggests that a Spigelian hernia, regardless of age of presentation, is congenital in origin.